title: The impact of thunderstorm asthma on emergency department attendances across London during July 2013.
abstract: BACKGROUND
  This study illustrates the potential of using emergency department attendance data, routinely accessed as part of a national syndromic surveillance system, to monitor the impact of thunderstorm asthma.
  
  
  METHODS
  The Emergency Department Syndromic Surveillance System (EDSSS) routinely monitors anonymised attendance data on a daily basis across a sentinel network of 35 emergency departments. Attendance data for asthma, wheeze and difficulty breathing are analysed on a daily basis.
  
  
  RESULTS
  A statistically significant spike in asthma attendances in two EDSSS emergency departments in London was detected on 23 July 2013, coinciding with a series of large violent thunderstorms across southern England. There was also an increase in the reported severity of these attendances.
  
  
  CONCLUSIONS
  This preliminary report illustrates the potential of the EDSSS to monitor the impact of thunderstorms on emergency department asthma attendances. Further work will focus on how this system can be used to quantify the impact on emergency departments, thus potentially improving resource planning and also adding to the thunderstorm asthma evidence-base.
authors.affiliation: Real-time Syndromic Surveillance Team, Public Health England, Birmingham, UK.
authors.forename: A J
authors.initials: AJ
authors.lastname: Elliot
authors.affiliation: Real-time Syndromic Surveillance Team, Public Health England, Birmingham, UK.
authors.forename: H E
authors.initials: HE
authors.lastname: Hughes
authors.affiliation: Emergency Department, Oxford Radcliffe Hospitals NHS Trust, Oxford, UK The College of Emergency Medicine, London, UK.
authors.forename: T C
authors.initials: TC
authors.lastname: Hughes
authors.affiliation: The College of Emergency Medicine, London, UK Emergency Department, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK.
authors.forename: T E
authors.initials: TE
authors.lastname: Locker
authors.affiliation: Emergency Department, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, UK.
authors.forename: R
authors.initials: R
authors.lastname: Brown
authors.affiliation: Met Office, Exeter, UK.
authors.forename: C
authors.initials: C
authors.lastname: Sarran
authors.affiliation: Met Office, Exeter, UK.
authors.forename: Y
authors.initials: Y
authors.lastname: Clewlow
authors.affiliation: Extreme Events and Health Protection, Public Health England, London, UK.
authors.forename: V
authors.initials: V
authors.lastname: Murray
authors.affiliation: Extreme Events and Health Protection, Public Health England, London, UK.
authors.forename: A
authors.initials: A
authors.lastname: Bone
authors.affiliation: Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Catchpole
authors.affiliation: Department of Global Health, Public Health England, London, UK.
authors.forename: B
authors.initials: B
authors.lastname: McCloskey
authors.affiliation: Real-time Syndromic Surveillance Team, Public Health England, Birmingham, UK.
authors.forename: G E
authors.initials: GE
authors.lastname: Smith
mesh_terms: D000293:Adolescent; D000328:Adult; D001249:Asthma / Q000453:epidemiology*; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D015994:Incidence; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D062486:Public Health Surveillance / Q000379:methods*; D012621:Seasons; D014887:Weather; D055815:Young Adult
keywords: asthma; emergency department; epidemiology; major incidents, epidemiology; research, epidemiology